EA Health Research Journal

Congenital Dyserythropoeitic Anaemia: A Case Report from Tanzania

2026-08-02T18:57:22+00:00

Background: Congenital Dyserythropoietic Anaemia (CDA) is an inherited anaemia characterised by ineffective red cell production and erythroblast structural abnormalities.
Case Report: We present a case of a 9 month old boy with leg pain and microcytic hypochromic anaemia of 5.8g/dL with reticulocytopenia, which was preceded by an episode of acute gastrointestinal infection. Upon investigation of the bone marrow aspirate findings were internuclear bridges between incompletely separated polychromatic erythroblasts highly suggestive of CDA type I within proper clinical settings.
Conclusion: Careful analysis of bone marrow aspirate through light microscopy should be done in any child presented with microcytic hypochromic anaemia with reticulocytopenia.

Psychosocial Stress Among Healthcare Workers in Rwanda: A Narrative Review

2026-08-02T18:57:22+00:00

Background: Psychosocial stress is a major occupational health issue worldwide, and it is especially severe among healthcare workers (HCWs) in resource-limited and post-conflict environments like Rwanda. Despite widespread acknowledgement of the burden, there is limited and fragmented evidence regarding its prevalence, contributing factors,and effective interventions for Rwandan HCWs.
Methods: This narrative review incorporated 35 peer reviewed studies, published from 2000 to 2025, which were
retrieved from PubMed, CINAHL, and Web of Science. The inclusion criteria for studies mandated an examination of psycho-social stress, burnout, anxiety, depression, or post-traumatic stress disorder (PTSD) within healthcare workers (HCWs) in Rwanda or comparable low and middle income country (LMIC) contexts. Thematic synthesis was employed across five key domains: prevalence, risk factors, coping strategies, organizational interventions, and health outcomes.
Results: The analysis indicated that Rwandan healthcare workers (HCWs) experienced considerable psychological and social distress. Specifically, over half of the HCWs at King Faisal Hospital reported burnout. In addition, 80% of the intensive care unit (ICU) nurses reported experiencing moderate to high levels of workplace stress. Major risk factors included high workloads, shortages of staff and medication, workplace violence, stigma, and lingering trauma from the 1994 genocide. Although adaptive coping mechanisms, including social support networks and religious practices, were frequently employed, maladaptive approaches such as alcohol consumption were also documented. Organizational interventions, such as mindfulness based programs, show potential; however, they necessitate cultural adaptation due to Rwanda’s predominant stigma and resource limitations.
Conclusion: Psychosocial stress affects HCWs’ mental health, job performance, and the safety of the patients. This poses a substantial threat to Rwanda’s healthcare system. There is an urgent need for culturally informed, scalable interventions and policy measures to safeguard HCW well-being and foster a resilient health workforce in Rwanda

Male Involvement in Antenatal Care, Women’s Reproductive and Child Health Service Utilisation, and Its Associated Factors: An Analytical Cross-Sectional Study in Dar es Salaam, Tanzania

2026-08-02T18:57:22+00:00

Background: Male involvement in antenatal care (ANC) is associated with improved maternal and child health
outcomes; however, its influence on women’s utilisation of reproductive and child health services remains unclear in
Tanzania. Although some studies have linked partner participation to increased use of skilled birth attendance, there is
limited evidence on whether women accompanied by their partners during ANC are more likely to utilise other essential
reproductive and child health services. This study, therefore, examines the extent of male involvement in ANC, women’s
uptake of key ANC-related services, and the factors that determine this utilisation.
Methods: An analytical cross-sectional study was conducted at a primary healthcare facility in Dar es Salaam, Tanzania,
involving 396 postnatal mothers who had delivered within the previous 3 to 18 months and attended under-five or family
planning clinics. The timeframe ensured completion of the 42-day postnatal check-up and likely return for immunisation
or family planning. Participants were selected consecutively, and data were collected using a structured questionnaire.
Analyses were conducted in STATA version 15 using a modified Poisson regression model, with statistical significance
defined as P<.05.
Results: Out of 396 women, more than half, 54.3% (n=215), were aged between 25 years and 34 years. Two-thirds
of women 67% (n=265) reported being accompanied by a partner at least once during antenatal care (ANC), and
62% (n=245) had partner attendance at their first ANC visit, indicating moderate male involvement in this setting. Male
involvement during ANC was associated with a 36% higher prevalence of early ANC initiation (adjusted prevalence
ratio [aPR] 1.36; 95% CI, 1.04 to 1.77). However, no significant association was observed between male involvement
and postnatal care (PNC) attendance within seven days postpartum or the use of modern family planning, indicating that
partner presence alone may not be sufficient to influence all aspects of reproductive and child health service utilisation.
Conclusion: Male involvement during antenatal care was associated with earlier ANC initiation, showing that partner
support can facilitate timely care-seeking. However, no significant association was found with postnatal care attendance
or modern family planning use, suggesting that partner presence alone may not influence all aspects of reproductive
and child health service utilisation. Interventions should therefore combine partner engagement with broader strategies
to promote comprehensive maternal and child health services

Improving Newborn Health Knowledge Through Structured Maternal Education in Dar es Salaam, Tanzania

2026-08-02T18:57:23+00:00

Background: Neonatal mortality remains high in low- and middle-income countries. Mothers’ knowledge of Essential
Newborn Care (ENC) and neonatal danger signs is crucial for promoting appropriate neonatal care, facilitating early
recognition of illness, and reducing neonatal mortality. Structured health education may improve maternal knowledge;
however, evidence of its effectiveness in routine hospital settings remains limited.
Objective: To evaluate the effectiveness of health education intervention on postnatal mothers’ knowledge of ENC
and neonatal danger signs.
Methods: A quasi-experimental pre–post study using independent cross-sectional samples was conducted among postnatal
mothers in four public hospitals in Dar es Salaam, Tanzania. The post- intervention survey (2021) included 825 mothers
and was compared with a pre-intervention sample of 825 mothers from 2019. A structured maternal health education
package was implemented between the two time points. Data were collected using structured questionnaires assessing
maternal knowledge of ENC and neonatal danger signs. Descriptive statistics and logistic regression analyses were
performed, adjusting for sociodemographic and care-related confounders. Statistical significance was set at P<.05.
Results: Post-intervention mothers had higher levels of education (34.7% vs 28.7%. P=.001), employment (10.2%
vs 5.2%; P=.001), and caesarean delivery (30.9% vs 21.9%; P=.025), but lower uptake of ≥4 antenatal care visits
(81.0% vs 85.4%; P=.003). A higher proportion of post- intervention mothers had heard of neonatal danger signs
(92.4% vs 85.8%; P<.001) and correctly identified at least 50% of them (41.6% vs 36.7%; P=.044). They were more
than twice as likely to correctly identify danger signs (adjusted OR, 2.38; 95% CI, 1.63–3.48). Maternal knowledge
was also positively associated with ≥4 antenatal care visits, receipt of postnatal health education, and delivery at lower
volume hospitals.
Conclusion: The structured health education intervention was associated with higher maternal knowledge of neonatal
danger signs and ENC, although gaps remained in breastfeeding and some infection prevention practices. Knowledge
was greater among mothers with four or more antenatal care visits, those delivering at lower-volume hospitals, and
those exposed to postnatal education. Future longitudinal studies are needed to assess knowledge retention and how it
translates into actual newborn care practices.

Lytic Bacteriophage as an Alternative to Antibiotics for Controlling Multidrug-Resistant Bacteria Isolated from Human, Animal, and Environmental Samples in Tanzania

2026-08-02T18:57:23+00:00

Background: The rise of multidrug-resistant bacteria poses a significant global health threat, outpacing the development
of new antibiotics and potentially reverting medical practices to a pre-antibiotic era. Despite advancements in antibiotic
therapies for various diseases, rising antibiotic resistance rates have shifted focus towards alternative treatments, including
the use of bacteriophages, capable of targeting antibiotic-resistant bacteria. Therefore, this study aimed to investigate the
use of lytic bacteriophages as an alternative to antibiotics in controlling bacteria isolated from clinical and environmental
samples in Moshi, Kilimanjaro, Tanzania.
Methodology: A cross-sectional study was conducted from May to July 2023, involving clinical and environmental
components. Clinical bacterial isolates were obtained from Kilimanjaro Christian Medical Centre (KCMC), while
environmental bacteria were collected from soil, animal waste, and wastewater samples. Standard microbiological
methods were used for bacterial isolation, identification, and antimicrobial susceptibility testing. Bacteriophages were
isolated from wastewater samples using enrichment techniques, and their lytic activity was evaluated against bacterial
isolates by spot assays. Data were analysed using descriptive statistics to summarise the distribution of bacterial isolates
and bacteriophage activity across different sample types.
Results: A total of 7, 20, 16, and 26 bacterial isolates were obtained from clinical samples, soil, animal waste,
and wastewater, respectively. The predominant bacterial species included Escherichia coli, Pseudomonas aeruginosa,
Klebsiella pneumoniae, and Staphylococcus aureus. Bacteriophages isolated from wastewater showed lytic activity
against bacteria from soil, animal waste, and clinical samples, with activity mainly observed at lower dilutions (10⁰
10⁻²). A decline in bacteriophage activity was observed with increasing dilution, with most isolates showing resistance
at higher dilutions (≥10⁻³). Environmental isolates were generally more susceptible to bacteriophage activity compared
to clinical isolates.
Conclusion: Bacteriophages isolated in this study exhibited lytic activity against multidrug-resistant bacteria from
environmental and clinical sources, particularly at lower dilutions. These findings suggest their potential as alternative or
adjunct antibacterial agents within a One Health framework. However, further molecular characterisation and in vivo
studies are required before therapeutic application.

ConceptPrEP-on-Demand: Digital, on-Demand HIV Prevention and Contraceptive Delivery Intervention for Adolescent Girls and Young Women in Southwestern Kenya

2026-08-02T18:57:23+00:00

Background: Adolescent girls and young women (AGYW) in sub-Saharan Africa experience high rates of HIV infection
and unintended pregnancy, yet continuation of pre-exposure prophylaxis (PrEP) and non-barrier contraception remains
suboptimal. Digital health interventions (DHIs) offer promise for improving access and autonomy, but their effectiveness
in sustaining prevention behaviours remains not well established.
Objectives: To evaluate the acceptability, feasibility, and 6-month continuation of PrEP and non-barrier contraceptive
use among AGYW using ConceptPrEP-on-demand, a digital, on-demand HIV prevention and contraceptive delivery
intervention, compared with standard facility-based care.
Methods: We conducted a prospective quasi-experimental pilot study between February and December 2023 among
205 AGYW aged 16 to 24 years in Kisumu County, Kenya, at two health facilities providing primary-level sexual
and reproductive health services. Participants self-selected into the digital intervention or the standard-of-care arm in
a non-randomised 1:1 allocation (104 digital; 101 standard). The digital platform provided tele-counselling, online
ordering of SRH commodities, and discreet delivery. The standard-of-care arm received clinic-based PrEP according
to the Kenya national guidelines. Structured surveys were administered at baseline, 3 months, and 6 months post
enrolment via REDCap. Primary outcomes were continuation of PrEP and non-barrier contraceptive methods at 3 and 6
months. Secondary outcomes included intervention acceptability and predictors of continuation. Data were analysed
using descriptive statistics and multivariable Poisson regression with generalised estimating equations (GEE) using an
exchangeable working correlation structure and robust standard errors. Analyses were performed in Stata 18.1, with
statistical significance set at P<.05.
Results: Among 205 participants (104 digital, 101 standard), PrEP continuation at 6 months was lower in the digital
arm (34.4%) compared with the standard-of-care arm (72.0%) (P<.001). Contraceptive continuation also declined in
the digital arm (84.5% vs. 94.7%, P=.036). Multivariable analysis showed that participants in the standard arm were
31% more likely to continue PrEP (adjusted IRR,1.31; 95% CI, 1.05 to1.63). Acceptability of the digital intervention was
high, with 85.1% expressing interest in future use.
Conclusion: These hypothesis-generating findings suggest that digital, on-demand platforms in this context may require
accountability mechanisms and adaptive support to sustain prevention behaviours. Future adequately powered
randomized trials are needed to confirm these signals.

Predictors of Hepatitis B Virus Vaccine Uptake Among Women of Reproductive Age, in South Sudan: Conceptualising Health Belief Model

2026-08-02T18:57:23+00:00

Background: Hepatitis B virus (HBV) remains a public health problem in South Sudan. Vaccination is currently the most
effective means of protection against HBV infection. However, there is limited evidence regarding the uptake of the
vaccine among women of reproductive age (WRA) in South Sudan. This study aimed to examine the predictors of HBV
vaccine uptake among WRA in Juba City, South Sudan.
Methods: This study adopted a mixed methods cross-sectional design with quantitative and qualitative components
among WRA accessing health services at seven health facilities in Juba, South Sudan from May to July 2024. A validated
semi-structured questionnaire was used to collect data related to HBV vaccine uptake, women characteristics, health
behaviour factors from the 1808 randomly selected women. The study used Stata version 15 and ATLAS.ti version 7 for
analyses. Chi squared tests and regression model were performed to determine associations and likelihood, respectively.
Results: Among the 1,808 women, 37.7% received HBV vaccine as observed uptake and 65.8% as model’s predicted
uptake. Of those who received the vaccine, 56.9% had full dose. The demographic factors associated with uptake
of HBV vaccine were; residential area (p<.001), level of education (p<.001), employment status (p<.001). Similarly,
health behaviours associated with uptake of vaccine were; blood transfusion (p<.001), and surgical operation (p<.001).
The women who attended formal education were two times more likely to receive HBV vaccine compared to those who
did not (OR 1.988, 95% CI: 1.508 - 2.621). Employed women of reproductive age were two times more likely to
receive HBV vaccine than the unemployed (OR 1.676, 95 CI: 1.339 - 2.097). Women who had close contact with
a case of hepatitis B were two times more likely to receive the vaccine than those who had not had close contact with
a case of hepatitis B (OR 1.509, 95% CI:1.13 - 2.016). The study identified these themes: benefits of HBV vaccine
uptake (prevention of HBV and its complications, prevention of vertical transmission and social benefit (herd immunity)).
Furthermore, the results of major theme of barriers to HBV vaccine uptake included lack of vaccine information, limited
access to vaccination, fear of adverse reactions, and financial constraints.
Conclusion: HBV vaccine uptake among women of reproductive age in Juba city remains suboptimal. Uptake was
associated with residential area, level of education, employment status, blood transfusion history, and surgical operation
history. The study recommends strengthening tailored health promotion interventions, addressing identified barriers,
expanding antenatal HBV screening, and providing continuous in-service training for health workers

Knowledge and Attitude of Adolescent Females in Embakasi West Sub-County, Kenya towards HPV Vaccine and Cervical Cancer

2026-08-02T18:57:23+00:00

Background: The Human Papillomavirus (HPV) vaccine is recommended for adolescents and young adults to protect
against HPV-related diseases such as cervical cancer. Knowledge and attitudes towards HPV and vaccine uptake
influence decision making and subsequent uptake. However, no published data currently exists on these factors in
Embakasi West Sub-County, Kenya.
Objective: To assess the knowledge and attitudes of adolescent schoolgirls in Embakasi West Sub-County, Kenya
towards HPV and the HPV vaccine.
Methods: A cross-sectional analytical study was undertaken among school-going adolescent girls in Embakasi West
Sub-County, Kenya using a self-administered questionnaire and Focus Group Discussions (FGDs). Quantitative data was
analysed using IBM SPSS version 29, with statistical significancy set at α =.05. Qualitative data was digitally recorded,
transcribed verbatim, and analysed thematically.
Results: The mean age of participants was 12.59 ± 1.15 years. School (56.9%), health workers (25.3%), and parents
(12.9%) were the prominent sources of information about HPV and the vaccine. More than half of the participants
(56.1%) had poor uptake of the HPV vaccine. Awareness of the HPV vaccine ((P<.001), knowledge of HPV susceptibility
(P=.041) , Knowledge of virus transmission ((P=.03), and beliefs regarding injection pain ((P=.008) were significantly
associated with vaccine uptake. Majority of the participants (74.7%) had good knowledge. Less than half (45.3%) had
a positive attitude towards HPV and the vaccine. Girls without awareness were about 4.7 times more likely to have poor
uptake compared to those with awareness (OR, 4.689 [95% CI, 1.905–11.543]; (P=.001).
Conclusion: Adolescent girls in Embakasi West Sub-County demonstrated generally good knowledge but predominantly
negative attitudes towards HPV and the HPV vaccine. Lack of awareness was a key predictor of poor vaccine uptake,
highlighting the importance of sustained health education. Strengthening school-based health education and promoting
parent–child and peer-to-peer communication may improve awareness, attitudes, and vaccine uptake

Prevalence and Factors for Urinary Schistosomiasis Acquisition Among HIV Positive Women Living in Lower Moshi, Tanzania: A Cross Sectional, Hospital Based Study

2026-08-02T18:57:23+00:00

Background: Schistosomiasis is a neglected tropical disease endemic in sub-Saharan Africa and remains a major public
health concern in rural farming communities. In women of reproductive age, infection is associated with significant
morbidity and may increase susceptibility to HIV infection, making co-infection an important health challenge in endemic
settings such as Tanzania. However, limited data exist on its burden and determinants among HIV positive women. This
study assessed the prevalence and associated factors of schistosomiasis among HIV positive women in Moshi, Tanzania.
Methodology: A hospital based cross sectional study was conducted in Moshi from April to June 2021 among 260
HIV positive women aged 18 years to 49 years attending Care and Treatment Clinics. Systematic sampling was used.
Urine samples were examined for Schistosoma haematobium eggs using the membrane filtration technique. Data were
analysed using chi-square tests and logistic regression, with multivariate analysis used to control for confounding factors.
A P value of less than .05 was considered statistically significant.
Results: A total of 260 HIV positive women were enrolled in the study. Most participants were aged 31years to 40 years
120 (46.2%) and had primary education 206 (79.2%). The overall prevalence of schistosomiasis was 13 (5%). The
infection was slightly less common among women aged less than 30 years 2 (15.4%). In multivariate logistic regression
analysis, previous history of schistosomiasis infection was strongly associated with current infection (AOR=40.0, 95%
CI: 6.5–240.0, P<.001). Use of river water for domestic purposes was also significantly associated with infection
(AOR=5.8, 95% CI: 1.2–26.0, P=.02). In addition, frequent contact with dam/pond water was independently
associated with schistosomiasis infection (AOR=2.5, 95% CI: 1.0–6.5, P=.04).
Conclusion: Schistosomiasis remains present among HIV positive women in Lower Moshi, although at a low prevalence.
Environmental exposure, particularly contact with unsafe and stagnant water sources, together with a history of previous
infection, were the main predictors of infection. The findings highlight the need for integrated control strategies targeting
both schistosomiasis and HIV in high-risk rural populations, alongside improved access to safe water and sustained
health education

Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Adherence Among Female Sex Workers in Urban Tanzania: A Descriptive Qualitative Study

2026-08-02T18:57:23+00:00

Background: Oral pre-exposure prophylaxis (PrEP) is an established biomedical intervention for HIV prevention. Despite
the availability of PrEP, female sex workers (FSW) remain disproportionately affected by HIV. This study explored the
facilitators and barriers to PrEP adherence among the FSW participating in an HIV vaccine trial in Tanzania.
Methods: We conducted a descriptive, qualitative study nested within a multicentre, Phase IIb, three-arm, two-stage HIV
prophylactic vaccine trial with a second randomisation to compare two pre-exposure prophylaxis regimens (PrEPVacc
trial). We present findings from the Dar es Salaam site in Tanzania. Between 2021 and 2023, we conducted 15 in
depth interviews (IDIs) at three points and four focus group discussions (FGDs) among FSW enrolled in the HIV vaccine
trial. Data were analysed manually using framework and thematic content analysis approaches.
Results: Facilitators for PrEP adherence included perceived benefits of PrEP, manageable side effects, use of reminders,
establishing a friendly schedule for taking PrEP, the possibility of engaging in unprotected sex with clients whose HIV
status is unknown, concealing PrEP by taking it privately, linkage to trial participation, and a clear understanding of
the clinical protocol requirements. Barriers included the use of distinctive PrEP packaging, being away from home or
travelling without the pills, concerns about retaining clients for sex work while using PrEP, anxiety related to HIV stigma,
forgetfulness, and experiencing hunger.
Conclusion and recommendations: Both trial-related and individual-related factors affected PrEP adherence among the
FSW participating in the PrEPVacc trial. Trial participation, perceived benefits, manageable side effects, and personal
motivation supported adherence to PrEP, while stigma reduced consistent use. Tailored education and stigma-reduction
strategies are necessary to enhance PrEP adherence among the FSW.

Factors Associated with Human Papillomavirus Vaccine Uptake Among Secondary School Girls in Ubungo, Dar es Salaam: An Analytical Cross-Sectional Study

2026-08-02T18:57:24+00:00

Background: Human papillomavirus (HPV) vaccination is a key primary prevention strategy for cervical cancer, yet
vaccine completion remains uneven in many low- and middle-income settings. In Tanzania, HPV vaccination has been
delivered through school-based, health-facility-based, and community outreach platforms. Local evidence is needed to
understand uptake and barriers among in-school adolescents in urban settings.
Methods: An analytical cross-sectional study was conducted among 500 secondary school girls aged 14 to16 years in
Ubungo Municipal Council, Dar es Salaam, Tanzania. Participants were selected using a two-stage sampling procedure
from government and private secondary schools. Data were collected using a structured self-administered questionnaire.
Full HPV vaccination was defined as self-reported receipt of two HPV vaccine doses. Frequencies and percentages were
used to describe vaccination status and reported barriers. Logistic regression was used to identify factors associated with
full vaccination.
Results: Overall, 121 girls (24.2%) had received two HPV vaccine doses, 98 (19.6%) had received one dose, and
281 (56.2%) had never received the HPV vaccine. Full vaccination increased with age and class level. In multivariable
analysis, full vaccination was independently associated with age 16 years (aOR 3.73, 95% CI 1.77 to 8.26), Form 4
class level (aOR 4.88, 95% CI 1.65 to 12.77), basic HPV vaccine knowledge (aOR 5.38, 95% CI 2.32 to 12.46),
health-facility visit in the previous six months (aOR 2.06, 95% CI 1.21 to 3.51), and healthcare-provider encouragement
(aOR 2.79, 95% CI 1.59 to 4.87). Among 110 never-vaccinated girls who were unwilling to receive HPV vaccine, the
most common barriers were wanting more information (80.0%), parental or guardian refusal (58.2%), fear of side effects
(56.4%), fluctuating vaccine availability (46.4%), and not knowing where to obtain the vaccine (43.6%).
Conclusion: Full HPV vaccination coverage among secondary school girls in Ubungo Municipal Council was low. Uptake
was influenced by age, class level, HPV vaccine knowledge, recent contact with health services, and encouragement
from healthcare providers. Among unvaccinated girls who were unwilling to receive the vaccine, the main barriers
were informational gaps, parental influence, safety concerns, and difficulties navigating vaccination services. Improving
HPV vaccination in similar urban settings in Tanzania will require practical adolescent-focused education, targeted
communication with parents, strong and consistent recommendations from trusted healthcare providers, and better
coordination of vaccination services across both government and private schools.

Co-Infection of Helicobacter Pylori with Entamoeba Histolytica and Giardia Lamblia Among Patients with Dyspeptic Symptoms Attending Bugando Medical Center, Tanzania

2026-08-02T18:57:24+00:00

Background: Helicobacter pylori (H. pylori) and intestinal protozoa are common infections that pose a serious threat to
public health because they frequently cause gastrointestinal discomfort. There is a lack of information regarding the co
infection in Tanzanian tertiary hospitals, despite the high global prevalence of these infections. Due to the fact that both
H. pylori and intestinal protozoa share similar transmission routes and are influenced by socioeconomic factors, such
as poor sanitation and inadequate hygiene practices, co-infection is most likely. The aim of this study was to determine
the prevalence of co-infection between Helicobacter pylori and intestinal protozoa (Entamoeba histolytica and Giardia
lamblia) and assess factors associated with H. pylori infection among dyspeptic patients.
Methodology: A cross-sectional study was conducted with 277 participants who met the inclusion criteria between April
and July 2023 at BMC Mwanza. Stool samples from patients with dyspeptic symptoms were screened for H. pylori
using stool antigen test and examined for intestinal protozoa using formalin-ether concentration and wet preparation
methods. Data were analyzed using STATA version 13.0. Variables with P < .2 in univariate analysis were included in
multivariate logistic regression analysis. Statistical significance was considered at P < .05
Results: The prevalence of H. pylori was found to be 50.5%, while intestinal protozoa had a prevalence of 9.3%.
Female participants constituted 58.8% and the mean age was 37.9 ± 21.6 years. Co-infection with both pathogens
was observed in 5.1% of the participants. Water treatment, hand washing practices and consuming uncooked diet were
significantly associated with H. pylori infection
Conclusions: The study reveals a high prevalence of H. pylori infection and a notable co-infection rate with intestinal
protozoa (E. histolytica and G. lamblia). Factors associated with H. pylori infection included poor hand hygiene,
consumption of untreated water, and consumption of uncooked food. Due to the notable presence of co-infection
between H. pylori and intestinal protozoa. we suggest improvement of preventive measures and further researches on
this topic

Generalised Anxiety Symptoms Among Patients with Chronic Kidney Disease: A Cross-Sectional Study in Northwestern Tanzania

2026-08-02T18:57:24+00:00

Background: Generalized anxiety disorder is prevalent among patients with chronic diseases such as chronic kidney
disease (CKD). It is often not identified but is associated with reduced quality of life in patients with End Stage Renal
Disease. This study aimed to determine the prevalence of generalized anxiety symptoms and to identify factors associated
with these symptoms among patients with CKD attending Bugando Medical Centre, Mwanza, Northwestern Tanzania.
Methods: This was a cross-sectional study conducted among 376 patients with CKD aged 18 years and above who
were recruited and interviewed using the Generalized Anxiety Disorder-7 (GAD-7) scale to screen for symptoms of
generalized anxiety disorder. Participants were systematically selected from both inpatient and outpatient units and
interviewed by trained research assistants.
Results: The mean age of the participants was 52.78 years (SD=14.23; range 18-85 years). 67.02% were males;
33.24% were more than 60 years of age and 32.45% of the participants were attending haemodialysis at BMC
Nephrology unit. The prevalence of generalized anxiety symptoms was 40.96% (n=154, 95% CI: 36.07% - 46.03%).
Increased odds of anxiety symptoms were associated with being 41-50 years (AOR 3.6, 95%CI: 1.60-2.19, P
value=.016); not started dialysis treatment (AOR 2.48, 95% CI: 1.42-4.31, P value=.001), not having health insurance
coverage (AOR 1.29, 95% CI: 1.16-1.53, P value<.001) and inability to perform their personal duties (e.g.., bathing,
walking, and dressing without assistance) (AOR 1.78, 95% CI: 1.05-3.03, P value=.033).
Conclusion: Generalised anxiety symptoms are highly prevalent among patients with CKD at Bugando Medical Center
in Mwanza, Northwestern Tanzania. To support their psychosocial health, our findings suggest that patients with CKD
should be screened early for anxiety disorders. Early detection and intervention may reduce the burden of morbidity and
mortality and improve patients’ quality of life

Thyroid Dysfunction, Associated Factors and Glycaemic Control Among Patients with Diabetes Mellitus in a Tertiary Hospital

2026-08-02T18:57:24+00:00

Background: Diabetes mellitus and thyroid disorders are among the most common endocrine diseases. Thyroid
dysfunction is more prevalent among diabetic patients than in the general population. These two disorders affect each
other, making their management dependent on the control of both conditions. This study examined the prevalence of
thyroid dysfunction, associated factors and glycaemic control among diabetic patients at Muhimbili National Hospital.
Methods: This cross-sectional study among diabetic outpatients was conducted from September to November 2021.
Data was collected on sociodemographic, anthropometric and clinical characteristics. All patients underwent thyroid
gland neck examination. Blood samples were drawn for random blood glucose (RBG), glycated haemoglobin (HbA1C),
thyroid function tests [Triiodothyronine (T3), Tetraiodothyronine (T4) and Thyroid Stimulating Hormone (TSH)]. HbA1C
≥7% was defined as poor glycaemic control, while thyroid hormone levels outside the reference range were considered
indicative of thyroid dysfunction.
Categorical variables were summarized as proportions, while continuous variables were summarized as means. Chi-
square or Fischer’s exact test was used to compare proportions in categorical variables. Logistic regression was used to
analyse the predictors for thyroid dysfunction. The Akaike information model was used for analysis of the factors in the
multivariate model where a p value of <.05 was considered statistically significant.
Results: A total of 403 diabetic patients were studied. Of these, 75.7% were overweight or obese. Thyroid dysfunction was
present in 16/403 (3.97%) participants. Of the patients with thyroid dysfunction, 5/16 (31.25%) had hypothyroidism
and 11/16 (68.75%) had hyperthyroidism, both being subclinical. Female sex was the only significant predictor of
thyroid dysfunction in this study population [AOR 2.9 (1.01-8.3); p=.047]. Overall, 14/16 (87.5%) patients with
thyroid dysfunction had a poor glycaemic control.
Conclusion: In this study conducted in Tanzania, thyroid dysfunction had a low prevalence among patients with diabetes
mellitus, with females being at greater risk. Subclinical hyperthyroidism was more common than hypothyroidism. Poor
glycaemic control was observed in approximately three quarters of the studied diabetic patients. Hypertension and
overweight or obesity conditions were also common in the population studied. Future studies on thyroid dysfunction in
diverse populations, including patients with type I diabetes mellitus, in sub-Saharan Africa are warranted

Factors Associated with Mental Health Distress Among Undergraduate Nursing Students at the University of Nairobi, Kenya: A Cross-Sectional Study

2026-08-02T18:57:24+00:00

Background: Nursing students face an increased susceptibility to mental health distress. Despite growing evidence
of mental distress among university students globally, limited data exist on undergraduate nursing students in Kenya,
particularly regarding mental health distress and their help-seeking behaviours. Our objective was to investigate the
prevalence of mental distress, identify associated risk factors, and assess help-seeking behaviours among nursing students
specifically enrolled at the University of Nairobi.
Method: We employed a cross-sectional descriptive design with 203 undergraduate nursing students. The data collection
instrument was the WHO’s Self-Reporting Questionnaire (SRQ-20), administered via a Google Form.
Results: Most (57.63%) of the respondents were female. The majority were aged 18-22 years, and most lived on
campus. About 29.56% of the respondents reported potential mental distress. The most frequently reported symptoms
were daily academic work-related stress (61.08%), nervousness (49.75%), and difficulty paying attention (34.48%).
Family history of mental illness and drug use were significantly associated with mental distress among the nursing
students. Students in the third year of study reported lower levels of mental distress.
A significant majority either did not seek help for mental distress (16.3%) or did not disclose their help-seeking practices
(42.9%), highlighting potential barriers to mental health service utilisation. Only 13.3% specifically sought help from the
university students’ clinic.
Conclusion: This study found a high prevalence of potential mental distress associated with a family history of mental
illness and drug use, while advancement in academic years, especially the third year, appeared protective. The findings
highlight the need for improved mental health support and awareness among student nurses. There is need to review
the curriculum for workload distribution across the years of study and strengthen health systems to support mental health
services within and without the university

Prevalence and Factors Associated with Oesophageal Tumour among Patients Attending Tanga Regional Referral Hospital, Tanga Region, Tanzania

2026-08-02T18:57:24+00:00

Background: Despite the high incidence and mortality of oesophageal tumours in Tanzania, particularly in the Tanga
region, there is a lack of localised data on their prevalence and associated factors. This study aimed to determine the
prevalence and risk factors of oesophageal tumours at Tanga Regional Referral Hospital (TRRH), Tanzania.
Methods: This retrospective hospital-based record review study utilised data from patients aged 18 and above who
underwent endoscopy diagnostic services at TRRH’s surgical department. Data were extracted from the patient register
for those who underwent endoscopy diagnostic services from July 2022 to July 2024 and analysed using descriptive
statistics, chi-square tests, and univariate and multivariate analyses to estimate adjusted odds ratios (AOR) and 95%
confidence intervals (CI) for associations between oesophageal tumours and various associated factors.
Results: Among the 246 study participants, the majority were aged >50 years (58.1%). The most common clinical
finding was “other endoscopic diagnoses” (51.2%), with mass lesions and bleeding each accounting for 13.8%.
Tumours were most frequently located in the middle oesophagus (23.2%). The overall prevalence of oesophageal
tumours was higher in smokers (55.1%) and those who underwent a biopsy (75.5%). Significant risk factors included
smoking (AOR=2.92, P=.001), and a low-fat diet (AOR=3.00, P=.010), while age, sex, alcohol, and physical activity
were not statistically significant.
Conclusion: This study highlighted a notable prevalence of oesophageal tumours at TRRH. Individuals who smoke and
those with a low-fat diet were significantly associated with oesophageal tumour, emphasising the need for targeted
prevention and early diagnostic interventions.

Prevalence and Patterns of Hearing Loss Among Primary School Pupils in Dodoma Municipality, Tanzania

2026-08-02T18:57:24+00:00

Background: Hearing is one of the crucial senses during early childhood development, as it plays an essential role in language acquisition, speech development, and social interaction. This study aimed to determine the prevalence and patterns of hearing loss among primary school pupils in Dodoma Municipality
Methods: A cross-sectional study was conducted among children aged 5 to 15 years in eight public and private
primary schools in Dodoma Municipality. Hearing loss was assessed using a calibrated Amplivox 207 diagnostic
audiometer. Data were analyzed using Statistical Package for Social Sciences version 26, with descriptive statistics used to summarize participant characteristics and hearing loss patterns. Chi-square tests were used to examine associations between hearing loss and socio-demographic factors, with statistical significance set at P <.05.
Results: A total of 206 primary school pupils from eight schools were screened for hearing loss. Of these, 117 (56.8%)
were males and more than half of the pupils, 116 (56.3%), were from public schools. The prevalence of hearing loss was 5.3%, with conductive hearing loss accounting for the majority of cases (81.8%). Among the 11 pupils identified with hearing loss, 10 (90.9%) had mild hearing loss, while 1 (9.1%) had moderate hearing loss. Regarding lateralization of hearing loss, 45.5% had bilateral hearing loss and 54.5% had unilateral hearing loss, with the unilateral cases equally distributed between the left and right ears. A statistically significant association was observed between hearing loss and type of school attended, with all affected pupils coming from public schools.
Conclusion: Hearing loss was found to be present among primary school children, with conductive hearing loss being the predominant type. Most affected pupils had mild hearing loss, involving either one or both ears. Regular screening of hearing loss among primary school children should be conducted so that prompt treatment can be initiated for those affected

Healthcare Providers’ Perspectives on the Usefulness and Utilisation of Hypertension Management Guidelines in Primary Health Facilities: A Qualitative Study in Dodoma Municipality

2026-08-02T18:57:25+00:00

Background: Hypertension is a major modifiable risk factor for cardiovascular disease and premature mortality, with
a growing burden in low- and middle-income countries, including Tanzania, where awareness, treatment, and control
remain suboptimal. Clinical guidelines for hypertension management are essential tools that support healthcare providers
in delivering evidence-based care, particularly for those with limited training. In primary health care (PHC) settings,
effective implementation of these guidelines is pivotal for ensuring quality and standardised care. Despite the availability
of hypertension guidelines in Tanzania and the critical role of PHC providers in their application, hypertension prevalence
continues to rise in both rural and urban populations. Furthermore, evidence on healthcare providers’ perceptions of these
guidelines’ usefulness and application in PHC settings remains limited, despite its importance for improving adherence
and patient outcomes. This study aimed to explore healthcare providers’ perspectives on the usefulness and utilisation of
hypertension management guidelines in PHC facilities in Dodoma.
Methods: A descriptive qualitative study design was conducted in selected PHC facilities in Dodoma Municipality. A
total of 18 healthcare providers participated in four focus group discussions (FGDs) conducted in May and June 2024.
Participants were purposively selected based on their involvement in hypertension management. Data were collected
using an interview guide and analysed using a thematic analysis framework.
Results: Two main themes emerged. The first theme, the significance of hypertension management guidelines, included
four subthemes: supporting clinical decision-making; serving as reminders and clarifying care processes; enhancing
patient monitoring and follow-up; and facilitating patient counselling. The second theme, strategies to enhance guideline
utilisation, comprised regular guideline updates, on-the-job training, and improved accessibility within health facilities.
No substantial disconfirming views were reported; however, variability in emphasis on accessibility and training needs
was observed across participants.
Conclusion: Healthcare providers perceive hypertension management guidelines as essential tools for clinical decision
making, counselling, and follow-up. These findings reflect providers’ perspectives and suggest that strengthening guideline
updates, training, and accessibility may enhance utilisation. Future studies should include higher-level facilities to provide
a more comprehensive understanding of guideline implementation

Epilepsy Prevalence and Determinants in Four Former Health Provinces of Burundi: A Mixed Methods Study

2026-08-02T18:57:25+00:00

Background: Epilepsy remains one of the most prevalent neurological disorders globally, particularly in low-resource
settings. Understanding the factors associated with epilepsy, especially convulsive forms, is essential for effective
prevention and control strategies. This study aimed to determine the prevalence of epilepsy and identify associated
risk factors in four provinces of Burundi (Bujumbura Municipality, Gitega, Ngozi, and Rumonge, under the former
administrative organisation).
Methods: A mixed-methods approach was employed, combining a cross-sectional survey and a concurrent qualitative
component. The quantitative survey included 781 households within the catchment areas of selected health facilities.
Data were analysed using simple and multiple block binary logistic regression, with the best-fitting model selected using
the Bayesian Information Criterion.
Results: The overall prevalence rate of epilepsy was 10.9 per 10,000 people. Significant risk factors included
consumption of local traditional beer, pork consumption, foetal distress, non-caesarean delivery, sadness as a reported
trigger, and discontinuation of antiepileptic medications. The qualitative findings, based on in-depth interviews with
people with epilepsy and their care providers, highlighted limited awareness of epilepsy, delays in diagnosis, difficulty
accessing treatment, and persistent stigma. Observational visits to health facilities and private pharmacies further revealed
frequent shortages of antiepileptic drugs and inadequate treatment availability.
Conclusion: Epilepsy continues to be a major public health challenge in Burundi. Reducing its burden will require
increasing community awareness, enhancing early diagnosis and treatment through strengthened healthcare provider
capacity, ensuring a reliable supply of antiepileptic medications, and improving access to care for vulnerable populations.

Prevalence and Health-Seeking Behaviour Regarding Menstrual Disorders Among Non-Medical Undergraduate Students in Mwanza, Tanzania. A Cross-sectional Study

2026-08-02T18:57:25+00:00

Background: Menstrual disorders are a significant public health issue, particularly among young women in low- and
middle-income countries (LMICs). Health-seeking behaviour related to menstrual disorders among female undergraduate
students in sub-Saharan Africa remains suboptimal. This study aims to determine the prevalence, awareness, and health
seeking behaviours regarding menstrual disorders among female undergraduate students at non-medical universities.
Methods: This cross-sectional study was conducted between April and May 2022 at two institutions in Mwanza,
Tanzania: St Augustine University of Tanzania and the College of Business Education. The study population comprised
female undergraduate students aged 18 years or older, who were selected using a combined stratified and convenience
sampling approach. Data were collected via a structured, self-administered questionnaire. Descriptive statistics, including
frequencies, percentages, medians, and interquartile ranges (IQR), were used to summarise the data.
Results: A total of 573 participants were included in the study, the majority of whom were aged 22 to 25 years
(64.1%). The prevalence rates of menstrual disorders were as follows: dysmenorrhoea (73.0%), premenstrual syndrome
(54.3%), menorrhagia (44.0%), and amenorrhoea (37.0%). All participants were aware of the common menstrual
disorders. The primary sources of information regarding menstrual disorders were interpersonal communication (40.2%)
and the Internet (34.2%). Stress was identified as the most commonly perceived contributing factor of menstrual disorders
(54.3%), followed by the use of contraceptives (48.6%). Overall, 78.9% of participants reported seeking treatment
for their menstrual disorders; the most frequently cited sources of help were pharmaceutical outlets (40.7%), self-care
practices (50.7%), and hospitals (30.3%). Most participants sought help for menorrhagia (47.6%) and dysmenorrhea
(44.7%). The most commonly utilised treatments included analgesics (46.7%) and hormonal therapies (20.4%).
Conclusion: The findings highlight the considerable burden of menstrual disorders faced by female undergraduate
students, with dysmenorrhoea emerging as the most prevalent condition. The study also revealed that a significant
proportion of participants sought help for their menstrual disorders, with menorrhagia and dysmenorrhea being the
most commonly addressed conditions. Educational programmes should be integrated into university curricula to promote
menstrual health literacy

Challenges Limiting Healthcare Data Utilization for Policy Decision-Making in Tanzania: A Qualitative Panel Discussion

2026-08-02T18:57:25+00:00

Background: Accurate and reliable healthcare data are essential for effective policy decision-making, resource allocation,
and improved health outcomes. In Tanzania, despite various efforts to strengthen Health Management Information Systems
(HMIS), the utilisation of healthcare data in policy and planning remains limited. Existing studies highlight challenges
such as poor data quality, limited skills in data interpretation, and fragmented health information systems, yet there is
limited qualitative evidence capturing the lived experiences and perspectives of frontline stakeholders on these barriers.
This study was conducted to address this gap by identifying and contextualising the key obstacles that hinder healthcare
data utilisation for policy decision-making in Tanzania, using insights from a multidisciplinary expert panel discussion.
Methods: A qualitative research approach was employed, focusing on a panel discussion with five experts in the field
of health systems and Health Management Information Systems (HMIS) during the 8th Tanzania Health Summit. The
panellists were purposively selected, representing diverse backgrounds and expertise in healthcare data utilisation.
Data were primarily collected from the panellists’ presentations and audience interaction with those who attended the
session. An inductive semantic thematic analysis approach was used to identify the key obstacles limiting healthcare
data utilisation in Tanzania.
Results: The study identifies key obstacles limiting healthcare data utilisation in Tanzania, which include unskilled
professionals, multiple health information systems, poor data quality, competing donor priorities, poor communication,
healthcare staff fatigue, and low working morale. These challenges hinder effective data-driven decision-making and
healthcare service delivery. Addressing these obstacles requires a multifaceted approach involving collaboration among
stakeholders, investment in capacity building, harmonisation of health information systems, improved communication,
and prioritisation of healthcare worker well-being.
Conclusion: The findings of this study provide valuable insights into the challenges faced in healthcare data utilisation
for policy decision-making in Tanzania. Addressing these obstacles is critical for enhancing the capacity of healthcare
professionals, policymakers, and other stakeholders to make informed decisions based on accurate, high-quality
healthcare data. The study’s results can serve as a foundation for targeted interventions and policy recommendations
aimed at improving healthcare data utilisation in Tanzania and in similar resource-limited settings.

Socio-demographic Factors Influencing District Health Information System -2 (DHIS-2) Utilisation in Burundi: A Cross-sectional Study

2026-08-02T18:57:25+00:00

Background: The utilization of Electronic Health Information System is crucial in informing credible decision- making
process, especially in developing countries such as Burundi. This study aimed to investigate the socio-demographic
factors associated with Health Workers’ utilization of the District Health Information Software 2 (DHIS-2) platform in
Burundi.
Methods: A cross-sectional study was conducted among health workers involved in health data collecting and validating
in health facilities and health district offices in Burundi.
Results: Several socio-demographic factors were significantly associated with DHIS-2 platform utilisation in the Burundi
health system. Marital status (P=.011), education level (P=.007), gender (P=.005) and travel time from home to
workplace (P=.001) were associated with indicators related to DHIS-2 effects on data use. Travel time from home to
workplace was also associated with satisfaction with administrative support for DHIS-2 implementation (P = .001).
Further more, travel time from home to workplace (P =.030), profession role (P =.034), geographical area of work
(P<.001), and education level (P =.041) were associated with several DHIS-2 design related indicators.
Conclusion: Social-demographic factors are important considerations in the implementation and utilisation of DHIS
2 within the Burundi health system. Efforts to promote gender, educational, and professional equity, together with
interventions that improve workplace accessibility and support for health workers, may contribute to more effective and
sustainable DHIS-2 implementation.

Interest in Clinical Pharmacology as a Future Career Choice and Associated Factors Among Medical Students in Tanzania

2026-08-02T18:57:25+00:00

Background: Despite its critical role in drug development, research, patient care and drug safety, Clinical Pharmacology
remains one of the least preferred medical specialities among medical students, potentially threatening the future availability
of professionals in this essential field. In Tanzania and broader Sub-Saharan Africa, there is a lack of comprehensive
studies exploring medical students’ interest in clinical pharmacology and the factors influencing their career preferences.
This study uniquely addresses the underrepresentation of clinical pharmacology in career considerations by medical
students in Tanzania, aiming to uncover underlying causes and inform targeted strategies to elevate interest in this vital
speciality.
Methods: A cross-sectional study was conducted among 423 registered medical students in four universities in Tanzania.
An online self-administered questionnaire (Google Form) was used to collect data on socio-demographics, interest in
clinical pharmacology, knowledge of the potential roles of a clinical pharmacologist and attitude towards clinical
pharmacology. A robust Poisson regression model was performed to identify the factors associated with the choice of
clinical pharmacology as a future career choice.
Results: A total of 423 participants were enrolled in this study. The studied population’s median age (min, max age) was
24 years (20, 39). Almost half of the participants, 211/423 (49.9%), have shown interest in clinical pharmacology
as a future career. The main reason for those who did not show interest was preference for other specialities 100/212
(47.2%). Overall, about 61.5% (260/423) of the participants were knowledgeable about the potential roles of clinical
pharmacology. Only 13.9% (59/423) of the participants had a positive attitude towards clinical pharmacology
as a discipline. Married participants demonstrated lower interest compared to unmarried participants (aPR=0.85;
95% confidence interval [CI], 0.78 to 0.93; P<.001), while differences were also observed across academic year
categories, both third- and fourth-year students demonstrated slightly higher levels of interest in clinical pharmacology
compared to fifth year students (aPR 1.12; 95% CI, 1.01 to 1.26; P=.04 and aPR 1.16; 95% CI, 1.08 to 1.24;
P<.001 respectively). Notably, knowledge of the potential roles of clinical pharmacology did not predict interest in
clinical pharmacology.
Conclusions: This study highlights a moderate level of interest in clinical pharmacology as a future career among
medical students, with nearly half expressing such interest. Despite generally adequate knowledge regarding clinical
pharmacology, positive attitudes toward the speciality remains low, suggesting that factors beyond awareness alone
may influence career preferences among medical students. Marital status and year of study were the only demographic
variables significantly associated with career interest in this field. These findings underscore the need for targeted
strategies to enhance career guidance programs.

Nurse Prescribing Practices: An International Systematic Review with Implications for Tanzania

2026-08-02T18:57:25+00:00

Background: The role of nurse prescribing is increasingly expanding worldwide as the nursing profession evolves.
Several factors have driven its introduction into healthcare systems, including improving community health, increasing
patients’ access to medicines, optimizing nurses’ knowledge and skills, enhancing healthcare accessibility, increasing
nurses’ autonomy, and reducing physicians’ workload.
Objectives: This review aims to discuss nurses’ roles in prescribing medicines from an international perspective and within
the Tanzanian context, including current practices, opportunities, strategies, and challenges.
Methods: Four electronic databases, including CINAHL, PubMed/Medline, Cochrane Library, and PsycINFO, were
searched to identify peer-reviewed articles published in English between January 2015 and July 2025. Studies were
selected using predefined inclusion criteria and appraised using the Mixed Methods Appraisal Tool (MMAT) version 2018.
Results: Fourteen publications out of 4,217 retrieved articles were included in this study. Findings indicate that nurses
can prescribe medications depending on country legislation and educational qualifications. In some countries, nurse/
midwife specialists prescribe medicines without additional training because prescribing education is incorporated into
their curricula. In Tanzania, nurses’ prescribing roles remain unclear, as legislation does not authorize nurses to prescribe
independently without physician involvement. Furthermore, physician resistance and limited systems supporting continuity
of non-physician prescribing and patient experience monitoring were identified as major challenges to implementing
nurse prescribing.
Conclusion: Nurses’ authority to prescribe medicines varies across countries, depending on legislation and healthcare
systems. Many countries implementing nurse prescribing provides additional educational programs to support the role.
Legal implementation of nurse prescribing in Tanzania may provide important healthcare benefits